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首页> 外文期刊>Stroke: A Journal of Cerebral Circulation >Development of stroke performance measures: definitions, methods, and current measures.
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Development of stroke performance measures: definitions, methods, and current measures.

机译：制定中风表现指标：定义，方法和当前指标。

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BACKGROUND AND PURPOSE: In the United States and elsewhere, stroke performance measures have been developed to monitor and improve the quality of care. The process by which these measures are developed, implemented, and evaluated is complex, evolving, and not widely understood. We review the methodological development of stroke performance measures in the United States. METHODS: A literature search identified articles that addressed the development and endorsement of performance measures for stroke care. Emphasis was given to articles specific to acute stroke, but when these were lacking, other cardiovascular diseases were included. RESULTS: Ten process-based performance measures relevant to acute hospital-based stroke care have now been developed and endorsed. These measures include intravenous thrombolysis, deep vein thrombosis prophylaxis, dysphagia screening, stroke education, and discharge-related medications and assessments. There are currently at least 5 major US-based stroke quality improvement programs implementing stroke measures. Data indicate that rapid improvements in the quality of stroke care can be induced by the systematic collection and evaluation of stroke performance measures. However, current stroke measures are relatively limited, addressing only inpatient care and mostly patients with ischemic stroke. CONCLUSIONS: Stroke quality improvement is still in its early stages, but data suggest that large-scale improvements in stroke care can result from the implementation of stroke performance measures. Performance measures that address multidisciplinary stroke unit care, outpatient-based care, and patient-oriented outcomes such as functional recovery should be considered. Ongoing challenges relevant to stroke quality improvement include the role of public reporting and the need to link better stroke care to improved patient outcomes.
机译：背景和目的：在美国和其他地方，已开发出中风表现指标以监测和改善护理质量。开发，实施和评估这些措施的过程是复杂的，不断发展的，并且未被广泛理解。我们回顾了美国中风表现测量方法的发展。方法：通过文献检索确定了涉及卒中护理绩效测量指标发展和认可的文章。重点是针对急性中风的文章，但缺少这些文章时，还包括其他心血管疾病。结果：与基于医院的急性中风护理有关的十项基于过程的绩效指标现已得到开发和认可。这些措施包括静脉溶栓，预防深静脉血栓形成，吞咽困难筛查，中风教育以及与出院有关的药物和评估。目前，至少有5个主要的美国卒中质量改善计划实施了卒中措施。数据表明，可通过系统收集和评估卒中表现指标来迅速改善卒中护理质量。然而，当前的中风措施相对有限，仅针对住院治疗，并且主要针对缺血性中风患者。结论：卒中质量改善仍处于早期阶段，但数据表明，卒中表现措施的实施可导致卒中护理的大规模改善。应该考虑针对多学科卒中单元护理，基于门诊的护理以及以患者为导向的结果（例如功能恢复）的绩效指标。与中风质量改善相关的持续挑战包括公共报告的作用以及将更好的中风护理与改善患者预后相联系的需求。

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